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Nicotine Patches Fail Most Pregnant Smokers

Poor Adherence Seen in Nicotine Replacement Study; Safety Issue Still Not Settled
WebMD Health News
Reviewed by Laura J. Martin, MD

Feb. 29, 2012 -- Nicotine replacement therapy is widely used to help smokers kick the habit, but new research raises major doubts about its effectiveness during pregnancy.

The largest clinical trial ever to examine the use of nicotine patches in this setting found little evidence that the treatment helps pregnant women stop smoking.

Adherence with therapy was very low, with fewer than 1 in 10 women still wearing the patches after one month.

Nicotine Replacement During Pregnancy

Smoking during pregnancy increases the risk of miscarriage, preterm delivery, birth defects, and even sudden infant death.

Most women who smoke are highly motivated to stop when they become pregnant, but many are not successful.

Researcher Tim Coleman, MD, of the University of Nottingham in the United Kingdom, says it is clear that standard-dose nicotine replacement therapy is not a useful strategy for helping them achieve their goal. And at this point, it’s not clear if nicotine replacement is totally safe for pregnant women, adding to Coleman’s argument.

The study appears in the March 1 issue of The New England Journal of Medicine.

“There is no evidence that standard-dose nicotine replacement therapy works, so I can’t see much point in recommending it to women who are pregnant,” he says.

According to the CDC, about 45% of women who smoke prior to becoming pregnant give up the habit during pregnancy, but more than 1 in 10 women (13%) in the U.S. report smoking during their last three months of pregnancy.

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